Volume 92, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Prospectively collected, contemporary data are lacking on how the features of infective endocarditis (IE) vary according to region. We, therefore, compared IE in Rennes, France and Khon Kaen, Thailand. Fifty-eight patients with confirmed IE were enrolled at each site during 2011 and 2012 using a common protocol. Compared with French patients, Thais had a lower median age (47 versus 70 years old; < 0.001) and reported more animal contact (86% versus 21%; < 0.001). There were more zoonotic infections among Thai than France patients (6 and 1 cases; = 0.017) and fewer staphylococcal infections (4 versus 15 cases; = 0.011). Underlying rheumatic heart disease was more prevalent in Thai than in French patients (31% and 4%; = 0.001), whereas prosthetic heart valves were less prevalent (9% and 35%; = 0.001). Our data strengthen previous observations that IE in the tropics has distinctive demographic characteristics, risk factors, and etiologies and underscore the need for improved prevention and control strategies.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Thuny F, Grisoli D, Collart F, Habit G, Raoult D, , 2012. Management of infective endocarditis: challenges and perspectives. Lancet 379: 965975.[Crossref] [Google Scholar]
  2. Nkomo V, , 2007. Epidemiology and prevention of valvular heart diseases and infective endocarditis in Africa. Heart 93: 15101519.[Crossref] [Google Scholar]
  3. Seckeler MD, Hoke TR, , 2011. The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease. Clin Epidemiol 3: 6784.[Crossref] [Google Scholar]
  4. Balakrishnan N, Menon T, Fournier PE, Raoult D, , 2008. Bartonella quintana and Coxiella burnetii as causes of endocarditis, India. Emerg Infect Dis 14: 11681169.[Crossref] [Google Scholar]
  5. Benslimani A, Fenollar F, Lepidi H, Raoult D, , 2005. Bacterial zoonoses and infective endocarditis, Algeria. Emerg Infect Dis 11: 216224.[Crossref] [Google Scholar]
  6. Lamas C, Ramos RG, Lopes GQ, Santos MS, Golebiovski WF, Weksler C, Ferraiuoli GI, Fournier PE, Lepidi H, Raoult D, , 2013. Bartonella and Coxiella infective endocarditis in Brazil: molecular evidence from excised valves from a cardiac surgery referral center in Rio de Janeiro, Brazil, 1998 to 2009. Int J Infect Dis 17: e65e66.[Crossref] [Google Scholar]
  7. Murdoch DR, Corey GR, Hoen B, Miró JM, Fowler VG, Jr Bayer AS, Karchmer AW, Olaison L, Pappas PA, Moreillon P, Chambers ST, Chu VH, Falcó V, Holland DJ, Jones P, Klein JL, Raymond NJ, Read KM, Tripodi MF, Utili R, Wang A, Woods CW, Cabell CH, International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators; , 2009. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis – Prospective Cohort Study. Arch Intern Med 169: 463473.[Crossref] [Google Scholar]
  8. Selton-Suty C, Célard M, Le Moing V, Doco-Lecompte T, Chirouze C, Iung B, Strady C, Revest M, Vandenesch F, Bouvet A, Delahaye F, Alla F, Duval X, Hoen B, AEPEI Study Group; , 2012. Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey. Clin Infect Dis 54: 12301239.[Crossref] [Google Scholar]
  9. Ma XZ, Li XY, Que CL, Lu Y, , 2013. Underlying heart disease and microbiological spectrum of adult infective endocarditis in one Chinese university hospital: a 10-year retrospective study. Intern Med J 43: 13031309.[Crossref] [Google Scholar]
  10. Orathai P, Kosoy M, Bai Y, Prathani P, Puapairoj A, Zeidner N, Peruski LF, Baggett H, Watt G, Maloney SA, , 2011. The first reported case of Bartonella endocarditis in Thailand. Infect Dis Rep 3: 4445. [Google Scholar]
  11. World Bank, 2014. World Bank Online Data Catalog. Available at: http://data.worldbank.org/products/wdi. Accessed September 3, 2014. [Google Scholar]
  12. Li JS, Sexton DJ, Mick N, Nettles R, Fowler VG, Jr Ryan T, Bashore T, Corey GR, , 2000. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis 30: 633638.[Crossref] [Google Scholar]
  13. Fournier PE, Thuny F, Richet H, Lepidi H, Casalta J-P, Arzouni J-P, Maurin M, Celard M, Mainardi JL, Caus T, Collart F, Habib G, , 2010. Comprehensive diagnostic strategy for blood culture-negative endocarditis: a prospective study of 819 new cases. Clin Infect Dis 51: 131140.[Crossref] [Google Scholar]
  14. Houpikian P, Raoult D, , 2005. Blood culture-negative endocarditis in a reference center. Etiologic diagnosis of 348 cases. Medicine (Baltimore) 84: 162173.[Crossref] [Google Scholar]
  15. Tariq M, Alam M, Munir G, Khan MA, Smego RA, , 2004. Infective endocarditis: a five year experience at a tertiary care hospital in Pakistan. Int J Infect Dis 8: 163170.[Crossref] [Google Scholar]
  16. Letaief A, Boughzala E, Kaabia N, Ernez S, Abid F, Ben Chaabane T, Ben Jemaa M, Boujnah R, Chakroun M, Daoud M, Gaha R, Kafsi N, Khalfallah A, Slimane L, Zaouali M, , 2007. Epidemiology of infective endocarditis in Tunisia: a 10-year multicenter retrospective study. Int J Infect Dis 11: 430433.[Crossref] [Google Scholar]
  17. Webb R, Voss L, Roberts S, Hornung T, Rumball E, Lennon D, , 2014. Infective endocarditis in New Zealand children 1994–2012. Pediatr Infect Dis J 33: 437442.[Crossref] [Google Scholar]
  18. Math RS, Sharma G, Kothari SS, Kalavani M, Saxena A, Kumar AS, Bahl VK, , 2011. Prospective study of infective endocarditis from a developing country. Am Heart J 162: 633638.[Crossref] [Google Scholar]
  19. Pachirat O, Taksinachanekit S, Mootsikapun P, Kerdsin A, , 2012. Human Streptococcus suis endocarditis: echocardiographic features and clinical outcome. Clin Med Insights Cardiol 6: 119123.[Crossref] [Google Scholar]
  20. Wertheim HFL, Ho DTN, Taylor W, Schultsz C, , 2009. Streptococcus suis: an emerging human pathogen. Clin Infect Dis 48: 617625.[Crossref] [Google Scholar]
  21. Tayoro J, Besnier JM, Laudat P, Cattier B, Choutet P, , 1996. Infective endocarditis due to Streptococcus suis serotype 2. Eur J Clin Microbiol Infect Dis 15: 765766.[Crossref] [Google Scholar]
  22. Znazen A, Rolain JM, Hammami N, Kammoun S, Hammami A, Raoult D, , 2005. High prevalence of Bartonella quintana endocarditis in Sfax, Tunisia. Am J Trop Med Hyg 72: 503507. [Google Scholar]
  23. Carpetis JR, Steer AC, Mulholland EK, Weber M, , 2005. The global burden of group A streptococcal diseases. Lancet Infect Dis 5: 685694.[Crossref] [Google Scholar]
  24. Al Abri SS, Zahedi FI, Kurup PJ, Al-Jardani AK, Beeching NJ, , 2014. The epidemiology and outcomes of infective endocarditis in a tertiary care hospital in Oman. J Infect Public Health 10: 400406.[Crossref] [Google Scholar]
  25. Omokhodian SI, , 2006. Management of patients with rheumatic fever and rheumatic heart disease in Nigeria – need for a national system of primary, secondary and tertiary prevention. S Afr Med J 96: 237239. [Google Scholar]
  26. Carapetis JA, , 2008. Rheumatic heart disease in Asia. Circulation 118: 27482753.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 31 Oct 2014
  • Accepted : 13 Dec 2014
  • Published online : 01 Apr 2015

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error